- Nutrition -

The Diet Dilemma

Every body is unique, and yet most eating plans promise results for everyone. Sure, you want to eat right, but what’s right for you?

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Cut out the carbohydrates. Load up on carbohydrates. Get enough protein – but not too much! Avoid dairy. Unless it’s raw and from pasture-fed cows. And what’s the scoop again on all those “good” and “bad” fats? Never before have there been so many confusing messages about what constitutes a healthy diet.

Jennifer Aniston and other Hollywood size 2’s pledge allegiance to The Zone, but you tried it and – surprise! – it didn’t turn you into a movie star. Back in the real world, one friend has dropped a few pounds on the Atkins diet. Another swears by Weight Watchers, while a colleague insists that eating a diet that’s pegged to his blood type has not only shrunk his waist, but also made him less tired and clearer headed. A chiropractor suggests that a food sensitivity may be preventing you from losing weight. Your family practitioner raises her eyebrow at this advice, and suggests that you should simply reduce your caloric intake and eat a wide variety of foods from the Food Pyramid for that ever-elusive “balanced diet.”

Meanwhile, you’re battling a weight problem and a health challenge, and wondering whether you should be more worried about counting calories or getting adequate nutrients. You’ve got three of the latest diet and nutrition books sitting on your bedside table, and none of them agree. Trying to sort out what will work best for you can feel so overwhelming that it’s tempting to give up entirely. But you know you can’t. You’ve got to eat something after all. You just wish you had a better idea of what – or at least an idea of how to go about sorting out the solution.

In a nation where nearly two-thirds of the population is overweight and the healthcare system is in crisis, the average person has not only a right but a responsibility to be concerned about his or her diet. Being overweight puts you at increased risk for heart disease, diabetes and certain types of cancer. And even the health of a person who is at his or her “ideal” weight can still be compromised by a lackluster or inappropriate diet. Mood swings, fatigue, insomnia, cravings, inflammation, bloating, skin conditions, clogged sinuses and persistent attacks of bad gas can all be the byproducts of eating foods that don’t agree with your body – or eating the right foods in the wrong quantity, or on the wrong schedule. Over time, a diet that undernourishes or puts ongoing stress on your system can even be responsible for doing permanent damage to your DNA (see “Emerging from the Gene Pool,” page 32 of the printed version of Experience Life).

Most of us know that our diet impacts all these aspects of health and wellness, but depending on what is most important to us on a given day (or which headline we read last), we may go in search of “the right” diet or eating plan without fully examining all the variables. Particularly when it comes to losing weight, we may not understand the longer-term, individual implications of all the approaches we try on.

Beyond the Quick Fix

“People are always looking for a quick fix for weight loss,” says Daniella Chace, a nutritional consultant and whole-foods expert based in Hailey, Idaho. “However, most fad diets – like Atkins, for example – do not promote a healthy, sustainable way of eating.” In fact, Chace believes that the quick changes produced by many popular diets are really just the results of the body reacting to a sudden biochemical imbalance – the results of which are only temporary and leave the people who try them not only less healthy but also feeling frustrated, confused and duped.

The other problem, explains Chace, is that many people assume a healthy diet is all about achieving a certain weight, when in truth, far more of us should be concerned about eating for optimal nutrition and metabolic balance. After all, the primary purpose of the food we eat is to support a state of robust health and energy – something we tend to overlook in search of “supreme” flavor and “supersize” satisfaction, or in our desperate quest to fit back into the jeans we wore in college. But when we construct our eating strategies from either of these camps, or we yo-yo back and forth on various “miracle” diets, we too often end up selling our health down the river. We also end up disappointed, wondering how something that worked so well for so many others could have failed us so miserably.

So what’s the answer? The first hard truth is that, when it comes to establishing a healthy, long-term eating plan, there is no one-size-fits-all solution.

Certainly, there are general guidelines: Every human body needs a balance of protein, carbohydrate and fat (known as macronutrients) to produce energy and sustain itself. Taking in more calories than your body burns will make you gain weight, and so on. But that’s not the stuff that has everyone confused. The bigger quandaries are things like: “How much protein, carbs and fats should I be eating to maximize my metabolism? What kinds of food sources should I be getting my macronutrients from, how often should I be eating them, and in what combinations?”

Here again, there are general guidelines. Most (but not all) nutritional and weight-loss experts agree that you can roughly calculate your protein needs as a percentage of your lean body mass (which a trainer can help you figure). That percentage will vary from 0.4-0.9 grams per pound of lean body weight, depending on your activity level. You can then calculate desirable carb and fat ratios from that. This, more or less, is the foundation of most “Zone”-type approaches.

Most (but not all) experts also agree that getting these ratios right and consuming your nutrients during several small meals a day (e.g., four meals that include fist-sized portions of protein and complex carbs combined with lots of additional non-starchy vegetables, and some healthy fats added for flavor) is the best way to regulate blood sugar without overloading the metabolic system or interrupting energy supply. But again, macronutrient calculation methods vary, and what’s likely to be “the right ratios” for your body is a matter of some debate. Some say 40 percent of your calories should come from complex carbs, 30 percent from protein and 30 percent from healthy fat. Others swap those numbers around every which way.

Then there’s food sources. In nutritionally inclined circles, most experts can agree that you should get the majority of your nutrients from fresh, whole vegetables and fruits, lean meats, fish, legumes and whole grains. They’ll tell you that you should eat as wide a variety of these foods as you can (preferably organic), while minimizing your intake of refined and processed foods, starches, sugars as well as hydrogenated and partially hydrogenated oils (trans fats). But this is where all certainty breaks down and controversy sets in. It’s where all the experts start arguing with each other – and interestingly, it’s also where most people’s interest in diet and nutrition is suddenly piqued.

That’s because this is precisely where the headlines are made: Headlines about the power of this or that nutrient, about the fat-fighting powers of this or that amino acid; headlines about all the pros and cons of getting your proteins and carbs from this or that source; headlines about the well-publicized but little-read (and even less-understood) research studies that supposedly support all these arguments.

It’s all terribly fascinating and titillating, and some of it is useful, to be sure. But a lot of the information out there is contradictory and confusing. It applies better to some people than others, and since most of us don’t know anywhere near enough about human biology and nutrition – much less our personal nutritional profiles – to put it all in perspective, we’re rarely able to apply much of it to our advantage.

But that doesn’t stop us from trying. In all likelihood, one of the reasons that most of us can’t resist the promise of all these “latest findings” and “scientific breakthroughs” is that we really aren’t even coming close to following the more essential nutritional guidelines we’ve already learned – and in many cases, we don’t want to. In essence, we’re obsessed with learning everything about how to “fine tune” the efficiency of our engines even though we haven’t yet succeeded in getting them firing on all cylinders.

While the headlines give us hope, they also give us an excuse. Getting mired in all the proclamations and flitting from one dietary approach to another can provide a convenient distraction. Maybe we just need to fix this one thing about our diet, we tell ourselves, and it will all fall into place. Most of the time, though, that’s bunk.

Again, it’s not that all the research findings are useless or false. It’s just that until you have a baseline of good health and fitness habits established, it’s unlikely that any magic-bullet approach is going to help you much. The biggest danger of getting mired in all the factoids-come-lately is that they can totally distract you from the stuff that matters more.

Dealing With Decoys

Based on decades of experience tracking health and wellness topics for his award-winning national radio show, investigative reporter, author and natural-health expert Gary Null says he thinks we’ve been brainwashed into thinking about health and fitness in totally fragmented, dysfunctional ways – largely as a result of media-driven cultural influences. The sensationalist headlines and ads are one problem, says Null, but there are other distractions that make our quest for health even more complicated.

“The cult of celebrity has convinced us to try to achieve celebrity standards,” Null explains. “We want to look like them and live like them and do what they do – when in reality, these are some of the most unhappy, imbalanced and un-normal people around.” For the most part, he says, “movie and TV stars are the very last people we should be emulating.”

“Historically,” says Null, who holds a Ph.D. in nutrition and public health science, “we’ve also had more of a problem with who to believe than what to believe.” People are often willing to buy into diet and health ideas that come from celebrities or conventional medical doctors even when these individuals have little or no substantive expertise in nutritional health, and even when our own intuition or experience tells us their solutions probably won’t work.

Although Null is a vocal advocate for developing practical, personalized diet, exercise and supplementation strategies, and has written dozens of health and wellness books himself, he says he thinks this is an area where people can easily get their priorities out of whack. He asserts that the main reason people get hooked into obsessing about the details of “perfecting their diet” is that it’s far easier than dealing with bigger life problems – like unhappiness, stress and lack of purpose – that are manifesting as overweight, fatigue and ill health.

“If people worried first about living a life of joy and purpose, about weeding out the things that drain and distress them,” he asserts, “we wouldn’t have a diet and weight-loss industry.” Left to their own devices, Null believes, most people living happy, authentic, empowered lives simply don’t run into a great deal of trouble with food.

Many integrative- and conventional-health experts also suggest that in their undisturbed, healthy state, our bodies are surprisingly capable of creating and maintaining homeostasis with just about whatever comes down the hatch. It’s under the chronic stress of overwork, obligation and emotional duress that our bodies get run down and begin expressing the symptoms of chemical imbalance and intolerance. While we can adjust our diets to cope temporarily with these problems, we often then just continue to overdo it until even bigger health issues surface.

“A large part of the problem,” Null concludes, “is that we just don’t have many real-life people acting as holistic models for optimal health today. We have a lot of high-profile experts telling us what to do,” he says, “and a lot of celebrities showing us tiny (and often-retouched) parts of an attractive but unrealistic picture. Meanwhile, we have almost no one around us actually living in ways that are truly healthy, sustainable and life-enhancing.”

Drilling Down

Okay, so maybe your diet woes are the result of endemic cultural confusion, sublimation and stress. Maybe they are the result of ignoring basic, common-sense nutritional guidelines or following too many fad diets. Then again maybe – just maybe – there’s something about the general guidelines that really doesn’t work for you and your personal metabolism, or that doesn’t work as well as it should.

Clearly, within the scope of biological individuality, there is plenty of room for variation – variation that just isn’t taken into account by the general guidelines. For example, there’s a great deal of uncontested scientific evidence showing that people’s bodies are genetically endowed with very different metabolic quirks and nutritional requirements, and that these quirks and requirements can also vary hugely depending on diet, fitness, activity level, health, stress and environment.

“Everyone is as unique as their fingerprints,” says William Wolcott, a biochemical individuality expert and author of The Metabolic Typing Diet (Doubleday, 2000). “So, why would anyone ever think that one diet is right for everyone?” If you research individualized nutrition for a while, though, the answer to that rhetorical question becomes quickly apparent: Because doing anything else can get downright complicated.

Once you start looking at individual nutritional and metabolic factors, as opposed to widely accepted, but watered-down and often-contradictory recommendations for “general populations,” you begin gathering speed down a fascinating but little-traveled and very twisting road – one where it’s easy to become lost.

It turns out that your personal protein requirements, your nutritional requirements, your body’s insulin/glucagon response to carbohydrates and its requirement for specific forms of calcium, vitamin C and many other nutrients can all be very different from what the general guidelines would suggest. But finding out about those specifics is either a matter of extensive tracking and trial and error, or a good deal of laboratory testing, much of which must be repeated at regular intervals (see “Figuring It Out” sidebar at bottom of page). In all cases, it requires a lot of initiative on your part, and in some cases, it also requires an openness to unconventional clinical protocols.

“C’mon,” you say, “I just want to know what I ought to be eating.” Well, to borrow a line from Jack Nicholson in A Few Good Men, “You want the truth? YOU CAN’T HANDLE THE TRUTH!” At least that’s what many weight-loss, medical and nutritional experts suspect. They’re not being deliberately opaque, but many of them – even some who have closely followed recent advances in individualized nutrition – are concerned that the vast majority of the population, lacking rudimentary knowledge of metabolism and nutritional essentials, will only be further confused and overwhelmed by all these special-case, “individual variances.” Which is why they typically dispense general guidelines instead. At the end of the day, most of the general recommendations are mostly right for most people, the experts figure. So they don’t go into detail about those other details much. And maybe they’re right not to.

After all, how many of us really want to read up on the Krebs cycle (which forms the basis for our metabolism), or learn all about blood pH levels and oxidation rates (which help determine how your body will respond to certain foods and supplements). Who really wants to get their blood, hair and urine tested repeatedly, or know all the molecular details of digestion and energy production that dictate whether we feel great or weary after lunch?

The problem is, without understanding at least a little about how your body functions, it is nearly impossible to fully understand what a “balanced diet” really is, or why one person’s balanced diet is another’s poison platter. It’s also nearly impossible to weed safely through the piles of generalized diet and nutrition advice that are churned out daily with everyone and no one in particular in mind.

Sure, a lot of the basic recommendations (e.g., eat more vegetables, fewer starches) are right for most folks. But it’s what’s not discussed – all the little exceptions and specifications and provisos that hinge on complex individual biochemical factors and health conditions – that could make some of this advice a lot more relevant, useful and safe for you personally. And it’s those same factors that could make certain popular and alternative dietary approaches all wrong (see “Making Exceptions” sidebar at the bottom of the page).

Your Body, Your Type

You want to lose weight? Pick the wrong diet for your metabolism and personal nutritional needs and you could end up getting pudgier instead. You want to pack on muscle? Pick the wrong protein, or eat too much of it, and you could find yourself awash in acidified blood and kidney stones. Want to eat a “balanced” diet? Good luck finding any two people who agree on what that really means, and what is balanced for you.

This is precisely the class of conundrum that inspired William Wolcott to write The Metabolic Typing Diet in the first place. Wolcott is an acknowledged (though somewhat controversial) guru in a growing field of specialists concerned with developing eating and supplementation programs geared toward the biochemistry and metabolic needs of individuals. Based on the earlier work of researchers like William Kelly, George Watson and Roger Williams – and before them, Weston Price, Frances Pottenger and Royal Lee – most of their work revolves around the concept of “biochemical individuality.” This is the idea that no two individuals are alike on a physiological or biochemical level.

Wolcott and other metabolic-typing specialists believe that the first step a person must take toward finding their own ideal diet is to figure out some of the rudiments of their metabolism, or how their body produces and processes energy. According to Dr. Harold J. Kristal, co-author with James M. Haig of The Nutrition Solution: A Guide to Your Metabolic Type (North Atlantic Books, 2003), there are many different “metabolic types,” all of which process fuel somewhat differently, at different rates, and which require different kinds of food to produce stable hormonal, blood-glucose and blood-pH levels.

When blood-pH levels are balanced (most experts agree that nutrients are optimally absorbed and utilized by the body when those levels measure about 7.4), our bodies are healthy. When they’re not, and our blood levels get either overly acidic or overly alkaline, we not only tend to gain weight, but also have less energy and are more susceptible to diseases and nutritional imbalances of all kinds.

So what does this esoteric science talk mean to a person who is simply trying to piece together a healthy diet? Plenty. “If a person’s blood is on the acid side and a food she eats regularly is acid-forming in her body, that food will further acidify her blood and destabilize her metabolism,” says Kristal. But here’s the twist: While some people’s pH levels are balanced by a diet lower in fat and protein and higher in complex carbohydrates, other people are exactly the opposite.

Moreover, some “healthy” foods (like kale or cauliflower) that are alkaline-forming in one person may be acid-forming in a person of a different metabolic type. For this reason, say experts in Kristal’s camp, knowing your metabolic type is an important factor in choosing the foods that work best with your body’s chemistry.

Yes, your blood type can play a part in all this. But when it comes to figuring out what your diet should be, metabolic-typing experts want to know far more. Like whether you are a slow or fast oxidizer (the rate at which you process various nutrients), how well your metabolism tolerates infusions of blood sugar (glucose), whether you rely more heavily on your sympathetic or parasympathetic autonomic nervous system (ANS), and what impacts certain foods will have on you as a result. They’ve got lab tests and questionnaires for all of it. The thing is, though, many of these factors can change over time based on changes in behavior and environment, so defining certain aspects of your metabolic type can be a bit of a moving target, and a controversial proposition.

Steve DeBoer, MPH, RD, LD, a clinical dietician at the Mayo Medical Center in Rochester, Minn., also cautions that while interesting, many of these “personalized” dietary approaches are not backed by peer-reviewed research. “There are certainly some intriguing concepts out there,” he says. “But there is currently no compelling scientific evidence to support them.” DeBoer instead advises people who want to commit to a healthier diet to seek out advice from a registered dietician (they have the letters “RD” after their names), who can do an initial blood panel to measure the levels of vitamins and minerals in the body as well as check for anemia, cholesterol and blood sugar levels and thyroid function. The dietician then works in consultation with the client to put together a balanced eating program that takes into account their fitness level, lifestyle and weight goals.

Figuring It Out

Does all this sound way too complicated? Too clinical? If so, you can always fall back to the general and well-substantiated advice of eating a wide variety of whole foods (including a mix of high-quality protein, vegetables, whole grains, fruits and a moderate dose of healthy fats) while avoiding sugar, refined foods and hydrogenated or partially hydrogenated fats. Most well-respected weight-loss and health experts agree that until you’ve mastered these basics (and committed to a regular exercise schedule) there’s not a whole lot of point in finessing things further.

However, if you’re already doing all that, and exercising at an appropriate intensity and frequency, and you’re still having chronic health or weight problems, then it may be time to start experimenting with more individualized factors.

Ultimately, it’s up to each individual to decide how much research to put into developing his or her own “ideal” diet. But you’ll probably find that just learning about the metabolic effects of various foods makes some study worthwhile. The following is just a partial list of potential considerations, compiled from a variety of health sources, including the books, Web sites and experts referenced in this article (see resources).

Personal Balance: The first step is a big, long look at your life. If you are stressed, frustrated, lonely, or if you lack a sense of purpose, authenticity and pleasure in your life, it is extremely likely that your eating habits will reflect this – either through obsessively controlling food behavior, or through unconscious or destructive eating patterns. Under stress, it is also likely you will have difficulty digesting and assimilating what you eat. Get to the root of the problem by committing to honor and resolve your emotional, psychological and spiritual issues. As you remove burdens and incorporate more joy, integrity and enthusiasm in your life, your energy will increase and your eating will naturally become healthier, more balanced and intuitive. Fail to do this, and even the most meticulously designed eating plan will fail as the result of depleted neurotransmitters and excess stress hormones flooding your body (watch for more on coping with stress, see the related articles at right).

Macronutrient balancing: Proteins, carbs and fats are the major (macro) nutrient components that your body breaks down into smaller microcomponents, which include amino acids, glucose and fatty acids. But the typical “40-30-30” carb/protein/fat ratios aren’t right for everyone. Some types need more protein, some types need more carbs, and some may need more healthy fats. If you’re not sure where to start, you can always begin with some basic “Zone” calculations (www.zoneperfect.com) just for an idea of what those portions might look like on a plate. Then use some trial-and-error adjustments to determine more accurately just how much protein, carbs and fats your body requires (as measured in grams and percentages, cups or handfuls – whichever suits you) in order to fulfill its fundamental nutritional/hormonal requirements and maintain a steady supply of energy.

Watch how the food you eat impacts you. If you aren’t feeling great an hour after eating a particular meal or snack, make a mental note to try adjusting macronutrient ratios, quantities and combinations next time around. Just keep in mind that different individuals require different amounts of macronutrients to function optimally. Also remember that your activity and fitness levels play huge roles in determining the amount and schedule of macronutrients your body requires.

Metabolic type: Are you a “protein type,” “carbo type,” “mixed type” or “diabetic type”? If you’re interested in finding out, you can get tested by a pro (see Resources), you can take a shot at analyzing yourself (using a kit that includes self-tests for blood type, blood pH, glucose response, etc.), or you can speculate based on your blood type, background and numerous other guidelines supplied by experts like William Wolcott, Howard Kristal and Peter J. D’Adamo (Eat Right for Your Type). Knowing this information (or just understanding its implications) may guide you toward determining the proper macronutrient balance for your metabolism and identifying the foods most likely to be balancing or upsetting to your system.

Food allergies/sensitivities: If you’re using the right general eating strategy for your body weight, activity level and metabolic type, but are including a specific food or foods to which you have an intolerance, you could still be unwittingly depressing your metabolism and otherwise undermining your health. Food intolerances cause stress to your body, but they can also be the result of chronic stress, and like hormonal imbalances, they often dissipate or disappear when stress is removed. If you suspect an allergy or intolerance, you can either experiment with eliminating suspect foods or you can order a food-allergy test (like an ELISA or ALCAT test) through your doctor or other health professional (see “False Fat,” March 2003).

Health/medical issues: Even once you’ve ruled out allergies, there are still plenty of reasons you might want to avoid certain categories of foods and emphasize others. For example, people with cancer, thyroid trouble, heart disease, diabetes, excess or insufficient stomach acid, stomach ulcers, Candida and all sorts of other conditions must take special (and very different) dietary precautions to avoid exacerbating their problems. If you have or suspect a health condition, or you regularly experience belching, gas or cramping after eating, consult a nutrition-oriented doctor or health specialist for guidance, or do some research on your own about dietary factors known to be significant in affecting your condition.

Nutritional anomolies: Because of genetic quirks, heavy-metal toxicities and various other factors, some individuals either have a hard time absorbing and clearing specific nutrients, or they burn through them at rates far exceeding the norm. Either problem can result in health problems. The only way to know if you have a nutrient deficiency or toxicity, short of accurately observing and interpreting commonly recognized symptoms, is to get your blood, urine or hair samples tested by a nutritional lab. Although there are many health references designed to help laypeople interpret symptoms and treatments for common deficiencies, suspicions should always be followed up with lab tests, and serious deficiencies should always be treated by a medical or nutritional expert.

Lifestyle/Life Circumstance: Sports, activity level, stress levels – they all affect your nutritional needs. So do your life circumstances: Women who are pregnant, nursing or hoping to conceive have special nutritional requirements. So, in many cases, do injured, physically challenged people, older individuals and athletes.

Food selection: The quality and integrity of the food you eat matters! Eating fresh, unrefined, in-season, local and organic foods will enhance any diet. So will avoiding processed foods, refined flours and sugars (especially high-fructose corn syrup), food additives, hydrogenated and fractionated fats, excessive starches, alcohol and caffeine.

Common Sense: Remember, it’s important that you enjoy your food, and eating in general. Don’t get so caught up in the finer points of eating that you cause yourself undue anxiety, or rob meals of their potential for fun and pleasure. Ultimately, your job is to eat in a way that feels good and that leaves you feeling healthy and energetic (which obsessing about macronutrients may not).

If there’s one lesson to take away from all this individualized-diet advice, it is simply to get into the habit of monitoring your own reactions to the food you ingest. If you’ve got plenty of energy throughout the day, if your digestion is good, your weight is healthy, and you feel comfortably at ease in your body, you’re probably doing most of the important things right. And if you’re not, your body will eventually let you know. Your level of vigilance and proactive commitment is up to you.

The other thing is, even if you are a highly motivated health enthusiast, you don’t have to figure out all this stuff at once! In fact, suddenly and dramatically altering your diet can do a lot more harm than good. If you are intrigued by the concepts behind individualized nutrition, take some time to study and evaluate them, then gradually begin experiementing with the principles at your own pace and comfort level.

You might try keeping a food journal to track your responses to various foods, food combinations and eating schedules. NOt that organized? Every time you find yourself in an energy slump or gastric distress, just make a point of thinking about what you’ve been eating and whether it could be playing a part. Do the same every time you find yourself feeling terrific, too.

Over time, you’ll get a much clearer picture of what eating patterns work for you — and which would be much better left to “general populations.”

Making Exceptions

Many diet guidelines that make sense for most people can be harmful to others in certain circumstances. For example:

  • For those with underactive thyroid (hyperthyroidism), several foods, including broccoli, cauliflower, Brussels sprouts, spinach and peaches, can suppress thyroid activity even further unless they are cooked first. Ditto soy (cooked or uncooked). While it is sometimes recommended as a way to curb hot flashes during menopause, eating a diet high in soy is also known to interfere with iodine absorption in the gut and can reduce thyroid hormone synthesis. The estrogenic effects of soy are also a source of concern for many.
  • Eating more beef, chicken or fish may be a healthy way for most people to get their protein needs met, but too much protein can cause debilitating joint pain for a person who suffers from rheumatoid arthritis, and may upset the natural acid/alkaline balance in metabolic types who don’t require as much protein overall. Eating too much of some types of fish can also lead to heavy-metal toxicity.
  • Six to eight glasses of water a day may be the optimal recommendation to keep the body properly hydrated, but for people with poor digestion, drinking more than 4 ounces of any liquid during mealtime can dilute stomach acid and digestive enzymes that allow the body to break down food naturally.
  • Dairy products are a great source of calcium, but for people who are lactose intolerant, they may also cause stomach cramps and diarrhea.

The here is that there is no single food, supplement or piece of diet advice that is good for everyone all the time. If you have concerns about customizing your diet, do some homework. If you can afford it, consult a registered dietician, qualified nutritionist or other knowledgeable health professional who can steer you in the right direct.

 

 

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